Loop gain in paediatric sleep‐disordered breathing: A different story from adults

Amin, Raouf S.; Khoo, Michael C. K.

doi:10.1111/resp.13897

Cited by 3 publications

(2 citation statements)

References 10 publications

(14 reference statements)

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“…Although we fully considered the effects of obesity, anatomy, and lymphoproliferation in children, non-anatomical factors remain an essential part of the phenotyping analyses and for improving the prediction ability in future studies, such as loop gain. 37 , 38 …”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics Combined with Craniofacial Photographic Analysis in Children with Obstructive Sleep Apnea

Wang¹,

Xu²,

Zhao³

et al. 2023

NSS

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Purpose Distinguishing obstructive sleep apnea (OSA) in a high-risk population remains challenging. This study aimed to investigate clinical features to identify children with OSA combined with craniofacial photographic analysis. Methods One hundred and forty-five children (30 controls, 62 with primary snoring, and 53 with OSA) were included. Differences in general demographic characteristics and surface facial morphology among the groups were compared. Risk factors and prediction models for determining the presence of OSA (obstructive sleep apnea-hypopnea index>1) were developed using logistic regression analysis. Results The BMI (z-score), tonsil hypertrophy, and lower face width (adjusted age, gender, and BMI z-score) were showed significantly different in children with OSA compared with primary snoring and controls (adjusted p<0.05). The screening model based on clinical features and photography measurements correctly classified 79.3% of the children with 64.2% sensitivity and 89.1% specificity. The area under the curve of the model was 81.0 (95% CI, 73.5–98.4%). Conclusion A screening model based on clinical features and photography measurements would be helpful in clinical decision-making for children with highly suspected OSA if polysomnography remains inaccessible in resource-stretched healthcare systems.

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Section: Discussionmentioning

confidence: 99%

Clinical Characteristics Combined with Craniofacial Photographic Analysis in Children with Obstructive Sleep Apnea

Wang¹,

Xu²,

Zhao³

et al. 2023

NSS

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“…Instability of the control of ventilation is now increasingly recognized as a pathophysiological factor of OSAS, along with factors as anatomically compromised airways, low respiratory threshold and insufficient neuromuscular activation of pharyngeal dilators 2 . Nevertheless, the degree of contribution of ventilatory control abnormalities to the pathogenesis of OSAS in children remains debated 3 . Loop gain (LG), controller gain (CG), and plant gain (PG), which reflect the stability of ventilatory control, chemoreceptor sensitivity and the pulmonary control of blood gas in response to a change in ventilation, respectively, have been evaluated in children with OSAS.…”

Section: Introductionmentioning

confidence: 99%

Oropharyngeal obstruction and respiratory system compliance are linked to ventilatory control parameters in pediatric obstructive sleep apnea syndrome

Bokov

Boujemla

Matrot

et al. 2022

Sci Rep

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Instable ventilatory control is an endotypic trait of obstructive sleep apnea syndrome (OSAS). This study aimed to evaluate the relationships between the anatomical compromise of the upper (oro- and naso-pharynx) and lower airways and ventilatory control (measured by chemical loop gain) in otherwise healthy children suffering from moderate to severe OSAS (apnea hypopnea index ≥ 5/hour). The children underwent ear, nose and throat examination, measurement of impedance of the respiratory system that allowed characterizing peripheral lung mechanics using the extended Resistance-Inertance-Compliance model. Physiologically constrained analytical model based on tidal breathing analysis allowed for the computation of steady-state plant gain, steady-state controller gain (CG0) and steady-state loop gain (LG0). Medium-frequency components of the feedback control system were then deduced. Fifty children (median age 11.2 years) were enrolled. Oropharyngeal obstruction was associated with decreased CG0 (0.6 [0.2; 1.0] vs 1.5 [0.5; 6.6] L.s− 1.mmHg− 1, p = 0.038) and LG0 (0.4 [0.2; 1.1] vs 1.2 [0.4; 9.3], p = 0.027), while nasal obstruction did not modify ventilatory control parameters. In a multivariate analysis Medium-Frequency PG was negatively related to minute ventilation and respiratory system compliance. Both upper (tonsil hypertrophy) and lower (compliance of respiratory system) airways are linked to ventilatory control in children with moderate to severe OSAS.

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Obstructive sleep apnea in children with Down syndrome: contribution of upper airway and chemosensitivity

et al. 2023

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Loop gain in paediatric sleep‐disordered breathing: A different story from adults

Abstract: See related article

Cited by 3 publications

References 10 publications

Clinical Characteristics Combined with Craniofacial Photographic Analysis in Children with Obstructive Sleep Apnea

Clinical Characteristics Combined with Craniofacial Photographic Analysis in Children with Obstructive Sleep Apnea

Oropharyngeal obstruction and respiratory system compliance are linked to ventilatory control parameters in pediatric obstructive sleep apnea syndrome

Obstructive sleep apnea in children with Down syndrome: contribution of upper airway and chemosensitivity

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